The interview question bank

Competing duties with no perfect answer: consent, confidentiality, fairness.

• EthicsAdvanced·MMI station · MD, DO, PA

  A 9-year-old with measles begs you for the vaccine. The parents still refuse. Do you vaccinate?

  Autonomy and consent · Communication

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  Sample answer outline

  1. 1Spot the clinical detail: a child who already has measles won't be helped by the measles vaccine now. The priority is treating them, isolating them and protecting contacts.
  2. 2Explain the frame: a 9-year-old can't consent alone; parents decide unless their choice puts the child at serious risk.
  3. 3Explore the parents' reasons with respect and correct misinformation. The illness is a natural moment to revisit vaccines for the child's siblings and the child's other vaccines.
  4. 4Keep the child's voice in the room: acknowledge their fear and explain what will happen.
  5. 5Notify public health as required.

  What makes it work

  • Catching the clinical premise shows careful reading, which interviewers love.
  • It respects parents while still protecting children and the public.

  Avoid

  • Vaccinating against the parents' wishes without legal grounds.
  • Lecturing the parents.

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• EthicsAdvanced·MMI station · MD, DO, PA

  A patient with Down syndrome is pregnant and wants to keep the baby. Her mother and husband want her to have an abortion. What do you do?

  Autonomy and consent · Communication · Equity and access

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  1. 1Start from a presumption of capacity: Down syndrome alone does not mean she can't make this decision.
  2. 2Assess capacity for this specific choice, with supports: plain language, time, visual aids, a trusted advocate.
  3. 3Meet with her alone to hear her wishes free of pressure, and screen for coercion.
  4. 4Acknowledge the family's worries and bring them into planning support for her, not into overriding her.
  5. 5If capacity is truly lacking, follow legal surrogate processes and involve ethics, still centered on her values.

  What makes it work

  • It avoids the common trap of assuming disability means incapacity.
  • It treats the family as partners without handing them the decision.

  Avoid

  • Siding with the family because they seem more "reasonable".

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• EthicsAdvanced·MMI station · MD, DO

  A deaf couple doing IVF asks you to help them pick an embryo that will also be deaf. What do you do?

  Autonomy and consent · Cultural humility · Critical thinking

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  1. 1Acknowledge both views: many Deaf people see deafness as a culture and identity, not a disability. Others see choosing it as limiting the child's options.
  2. 2Name the principles in tension: the parents' reproductive autonomy and the future child's interests (sometimes called the right to an open future).
  3. 3Explore the couple's reasons with curiosity instead of assumptions.
  4. 4Check the law and clinic policy where you practice. If you decline on conscience, say so openly and explain the options.
  5. 5Recommend an ethics consultation, then give your reasoned position.

  What makes it work

  • It shows cultural humility without dodging a position.
  • Naming the principles makes the reasoning easy to follow.

  Avoid

  • Calling deafness simply a defect.
  • Ending on "it depends" with no view.

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• EthicsAdvanced·MMI station · MD, DO, PA, Nursing, Residency

  A mother refuses a life-saving blood transfusion for her 4-year-old because of her religious beliefs. What do you do?

  Autonomy and consent · Cultural humility · Patient safety

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  1. 1The child's best interests come first. Parents' right to refuse has limits when a child's life is at risk.
  2. 2Approach the mother with empathy, explore her beliefs and offer every acceptable alternative that is medically safe.
  3. 3Involve the senior physician, ethics and the hospital's legal team early. Courts can authorize treatment.
  4. 4In a true emergency, treat to save the child's life as the law allows.
  5. 5Protect the relationship: this family will still care for the child afterward.

  What makes it work

  • It shows exactly where autonomy ends: a parent deciding for a child.
  • It handles the family with compassion, not force alone.

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• EthicsAdvanced·MMI station · MD, DO

  A patient with severe depression and no terminal illness asks for medical assistance in dying. It's legal where you work. What do you do?

  Autonomy and consent · Empathy · Patient safety

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  1. 1Respond with compassion. Take the request seriously as an expression of suffering, and assess suicide risk now.
  2. 2Assess capacity carefully: depression can affect decisions, but it does not automatically remove capacity.
  3. 3Review treatment so far and offer the best available psychiatric care. Many jurisdictions require this before mental illness alone can qualify.
  4. 4Follow the legal process: safeguards, independent assessments, waiting periods, multidisciplinary review.
  5. 5Be open about your own values; if you object, refer without obstructing.

  What makes it work

  • It treats the person, not just the request.
  • It shows you know the extra safeguards for mental illness.

  Avoid

  • Dismissing the request outright, or approving it without assessment.

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• EthicsAdvanced·MMI station · MD, DO

  A patient asks you to amputate their perfectly healthy leg because it "doesn't feel like theirs." Do you?

  Autonomy and consent · Empathy · Critical thinking

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  1. 1Recognize body integrity dysphoria: a real, distressing condition, not a whim.
  2. 2Weigh autonomy against nonmaleficence. Doctors are not obliged to perform procedures that cause serious harm without clear benefit.
  3. 3Explore their experience, assess capacity, and refer for psychiatric support. Check for any risk of self-harm.
  4. 4Decline the surgery for now, kindly and clearly, and stay involved in their care.

  What makes it work

  • It treats the patient's distress as real while holding a clear line.

  Avoid

  • Mocking the request or ending the visit.

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• EthicsAdvanced·MMI station · Pharmacy

  A pharmacist has a personal objection to dispensing a legal medication. How should that be handled so the patient still gets care?

  Integrity · Autonomy and consent · Equity and access

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  1. 1Name both values: the pharmacist's conscience and the patient's right to timely, legal care.
  2. 2The key principle: an objection must never become a barrier. The patient leaves with the medication or a guaranteed path to it.
  3. 3Plan ahead: tell the employer in advance and arrange another pharmacist on shift or a warm referral nearby.
  4. 4Treat the patient with dignity: no lecturing, no delay, no judgment.
  5. 5Note that laws and board rules vary by state.

  What makes it work

  • It resolves the tension with a practical system, not a slogan.

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• EthicsAdvanced·MMI station · MD, DO, PA

  How would you explain informed consent to a minor who disagrees with their guardian?

  Autonomy and consent · Communication

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  How to approach ethical dilemma questions

  1. 1Clarify the facts and what you would want to know before acting.
  2. 2Name who is affected and the principles in tension: autonomy, doing good, avoiding harm, fairness, confidentiality.
  3. 3Walk through realistic options, starting with the least drastic.
  4. 4Choose a course of action, explain why, and say who you would involve.

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